Key result
Specific NOAC antidotes rapidly reverse anticoagulant effects during major bleeding.
Why the study?
Major or life-threatening bleeding events remain a concern in patients treated with NOACs due to the previous lack of specific antidotes and rapid reversal agents.
Do specific NOAC antidotes effectively reverse anticoagulation in patients experiencing major or life-threatening bleeding?
Do specific NOAC antidotes effectively reverse anticoagulation in patients experiencing major or life-threatening bleeding?
Highlights the recent development and clinical role of specific antidotes for reversing non-vitamin K oral anticoagulants during major bleeding events.
Availability of idarucizumab and andexanet alfa may aid NOAC reversal in bleeding; leaves open efficacy and safety in broader populations.
Over the recent years, new oral anticoagulant agents have been developed and entered the clinical arena, the direct or non-vitamin K oral anticoagulants (NOACs). Although more expensive, these agents have been proven as equivalent or superior to vitamin K antagonists in the treatment of non-valvular atrial fibrillation (AF) and venous thrombo-embolism with a lower incidence of intracerebral hemorrhage. Nevertheless, occurrence of major or life-threatening bleeding events is still quite possible. Thus, there is a major concern regarding the lack of a specific antidote and rapid reversal agent in such disastrous situations. Fortunately, the development of effective specific NOAC antidotes has recently made great advances, which are herein briefly reviewed.
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Manolis et al. (2016) conducted an editorial in Major bleeding associated with non-vitamin K oral anticoagulants. NOAC antidotes (idarucizumab, andexanet alfa, aripazine) was evaluated.
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